Does systemically administered azithromycin have an effect on gingival overgrowth? A systematic review.

Objective: The aim of this systematic review was to evaluate studies that analyzed the effect of systemically administered azithromycin (AZM) on cyclosporine A (CsA)-mediated gingival overgrowth (GO).

Study Design: A systematic literature search was performed for publications published by January 1, 2019, using electronic databases and hand search. Human clinical trials (>10 patients) with systemic administration of AZM and a follow-up of ≥6 months, published in the English or German language, were included.

Results: From 266 titles identified, 6 publications with data from 104 patients were included. A great heterogeneity in terms of sample size, administration/dosage regimen of AZM, consideration of potential confounders and measurement of GO was observed. Treatment duration with AZM ranged from 3 to 5 days with a maximum dosage of 500 mg/day, gingival response was measured by using various scoring systems. A synthesis of results, by using a vote counting method, was applied. In all included studies, a beneficial effect of systemically administered AZM with respect to a reduction of GO was documented.

Conclusions: Limited evidence from 6 case series suggests a positive effect of systemically administered AZM on the reduction of CsA-mediated GO. Azithromycin may be considered a potential alternative to surgical reduction of GO.